U.S. prisoners are 55 percent more likely to have diabetes and twice as likely to have HIV as people outside, says a report in the April 2009 American Journal of Public Health (AJPH). Yet they are less likely to get proper medical care.

The problem isn't new. In a 1995 AJPH article, Alan Berkman, MD, said, “Politicians allocate more money to build prisons, but [not] for [prison] health care. The result is less money each year for greater numbers of sick prisoners. The public health implications are obvious.”  Those implications, the new article shows, have come home to roost.

How does this affect the black community in particular? “Most prisoners—disproportionately minorities—will return to their communities,” says Andrew Wilper, MD, an author of the new report. “They bring with them the consequences of substandard health care behind bars—for example, increasing the burden of HIV/AIDS for their communities.”

Jacqueline Walker, of the ACLU National Prison Project, adds that deeming anyone unworthy of health care undermines community values. “These are our brothers and sisters,” she says. “They don't deserve to be mistreated and die.”

As the new AJPH report concludes, “The constitutional, public health and human rights imperatives of improving [prison] health care are clear.”